HHS Announces Updated Penalty Amounts for Certain Federal Law Violations

November 29, 2021
Michael Bivona
female employees back to work with masks on

The U.S. Department of Health and Human Services (HHS) has posted its most recent list of penalty increases for violations of several federal laws, most notably Summary of Benefits Coverage (SBC), Health Insurance Portability and Accountability Act (HIPAA), and Medicare Secondary Payer (MSP) laws.


- The penalty for failure to provide an SBC to a health plan participant or beneficiary has been increased to $1,190 per participant/beneficiary. 


- HIPAA has multiple levels of penalties for violations of its provisions.  Each tier carries a minimum and maximum penalty with an annual cap, all of which have increased as follows:

Tier one: Minimum penalty $120, maximum penalty $60,226, annual cap $1,806,757
Tier two: Minimum penalty $1,205, maximum penalty $60,226, annual cap $1,806,757
Tier three: Minimum penalty $12,045, maximum penalty $60,226, annual cap $1,806,757
Tier four: Minimum penalty $60,226, maximum penalty and annual cap $1,806,757


- The penalty for incentivizing an employee to terminate enrollment in or fail to enroll in a group health plan that would be primary to Medicare has been increased to $9,753. 

Employers should be aware of these increased penalties and update their employee documents with the most accurate information for 2022. 



Heather Reynolds, ESQ

CCO - Administrative Officer
FNA Insurance Services, Inc.
516-348-7199 |[email protected]



Michael Bivona

Compliance Paralegal
FNA Insurance Services, Inc.
516-348-7135 |[email protected]